Active NPI
Malinda Manzo, APN
- Family Nurse Practitioner
- Eads, TN
National Provider Identifier
1962663849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 011741
- Practice address
- 3161 Highway 64 Ste 100
Eads, TN 38028-3369 - Phone
- (901) 317-7958
- Fax
- (901) 201-4485
- NPI assigned
- Jun 23, 2008
- Last updated
- Sep 30, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 011741 | TN | Primary |
Addresses
Primary practice location
3161 Highway 64 Ste 100
Eads, TN 38028-3369
Mailing address
3161 Highway 64 Ste 100
Eads, TN 38028-3369
Phone (901) 317-7958
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011741 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKnight Clinic PLLC | Past | Accepting new patients | |
| Wilder Clinic | Past | Accepting new patients | |
| Raleigh Group P.C. | Past | Accepting new patients | |
| The Pediatric Clinic PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/26256/brand/1/csg/1/fhir/r4
- https://fhir-myrecord.cerner.com/r4/110cb3c6-b110-474f-9f37-1dc02438d0c6/
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Somerville, TN
- NPI 1043482649
-
- Pediatrics Physician
- Memphis, TN
- NPI 1831209873
-
- Pediatrics Physician
- Arlington, TN
- NPI 1962080614
-
- Family Medicine Physician
- Sunerville, TN
- NPI 1588675276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790726400000",
"number": "1962663849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3161 HIGHWAY 64 STE 100",
"city": "EADS",
"state": "TN",
"postal_code": "380283369",
"telephone_number": "901-317-7958",
"fax_number": "901-201-4485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3161 HIGHWAY 64 STE 100",
"city": "EADS",
"state": "TN",
"postal_code": "380283369",
"telephone_number": "901-317-7958",
"fax_number": "901-201-4485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZO",
"first_name": "MALINDA",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "011741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eads, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.